America is on the cusp of becoming a nation with two health care systems. This sharp division is the result of continued resistance to the Affordable Care Act (ACA), and it does greatest harm to residents where the resistance is greatest.

Two current developments are animating this division: One relates to state decisions about expanding Medicaid, and the other is the potential outcome of the Supreme Court case, King v. Burwell, which was brought by ACA opponents and was argued on March 4.

Every year at tax time, more than 2 million married taxpayers file returns separately from their spouse. Usually, consumers who are legally married are required to file a joint tax return with their spouse in order to receive financial assistance to lower the cost of buying health insurance through the marketplace. However, for some taxpayers, such as survivors of domestic violence, filing taxes jointly with a spouse may not be an option, as getting in contact with a spouse may be traumatic, dangerous, or prohibited by a restraining order.

Under the Affordable Care Act, no American can be denied coverage, charged a higher monthly premium, or sold a policy that excludes coverage of important health services just because he or she has a pre-existing condition. This is called pre-existing condition discrimination, and without the provisions in the Affordable Care Act that prohibit this, a lot of Americans would be affected.

According to new data released by the Department of Health and Human Services (HHS), Latinos—the racial and ethnic group with the highest uninsured rate in the nation—have much to gain from the Affordable Care Act. And yet, anecdotal evidence suggests that this population is not enrolling for health coverage at the level that one would expect for a group with such high numbers of uninsured.

Lately, the media have been covering three provisions—risk adjustment, reinsurance, and risk corridors—that were created by the Affordable Care Act. The new health law’s opponents have been highly critical of these provisions (risk corridors in particular), characterizing them as federal bailouts to insurance companies. Also known as the “three Rs,” these provisions allow insurance companies to manage the financial risk that they incurred when the Affordable Care Act prevented insurers from denying coverage or charging higher premiums to individuals with pre-existing conditions.